Has Psychiatry Been Corrupted Beyond Repair?

Fake science is causing real harm

We know that corporations can show few scruples in hiding the damage done by their products. Cigarette makers hid the link to lung cancer for decades. Energy companies and their political allies deny any link between burning fossil fuels and global warming. But no industry has been as systematic nor as successful as drug companies in infiltrating the knowledge base concerning their products. The results have been high profits. The top ten pharmaceutical companies in the Fortune 500 make more money than the other 490 companies combined.

Imagine this: What if every scientist studying global warming was paid by Exxon? New York would be underwater before anyone knew global warming even existed. Yet, that is exactly the state of scientific research in psychiatry. Over 80 percent of the psychiatric research studies conducted in academic medical centers are funded by the drug industry. And that's the good news. With increasing frequency, Big Pharma is paying marketing companies with no ties to academia to generate studies that put their products in the best possible light; they then pay academics to put their names on the resulting studies as authors, even though they had no participation in the research whatsoever. To see what results, take the example of Neurontin.

About 12 years ago, I noticed that many of my bipolar type II patients were being put on a new drug, Neurontin. None of my patients seemed to get much benefit from it, and most suffered side effects. Now, I understand why.

We now know from independent research--research not funded by drug companies--that Neurontin produces absolutely no benefit in the treatment of bipolar disorder. None. But then, why did we ever believe it did? The Neurontin story is a particularly egregious example of science run amok, but not an atypical one. Psychiatrists were falsely induced to prescribe a medicine that was both unsafe and ineffective.

The study that Warner Lambert used to prove Neurontin was effective for the treatment of bipolar disorder was flawed and titled toward positive results, according to a recent article published in the Archives of Internal Medicine. Even worse, evidence of adverse consequences in this study was suppressed: 73 patients in this trial had adverse reactions, and 11 patients died.

How did this happen? In 1993 Warner Lambert had a problem. Neurontin, their new anti-epilepsy drug, had been given only limited FDA approval for use only as a second line epilepsy drugs--it could only be used if other epilepsy drugs already on the market failed. "Neurontin was a turkey." Wrote Daniel Carlat in Unhinged. What to do?

The company hired marketing firms--not scientists--to produce scientific articles demonstrating the benefits of Neurontin for bipolar disorder, and paid physicians $1,000 a piece to allow their names to be listed as authors of the studies that they neither conducted nor wrote (and perhaps never even read).

While the FDA requires a reasonably high level of scientific evidence to approve a drug for the treatment of a specific condition, once the drug is approved, doctors are free to prescribe any drug for any condition, off label. To convince them to do this, weak or massaged data can be dressed up to prove a drug is effective, and no FDA scrutiny is required. It's a crime for a drug company to market drugs to doctors for off label purposes, but that's exactly what happened. Marcia Angell, former editor of the New England Journal of Medicine, wrote: "the company had carried out a massive illegal scheme to promote Neurontin for off label uses--mainly by paying academic experts to put their names on flimsy research."

Drug reps descended on practicing psychiatrists. Warner Lambert senior executive John Ford exhorted his reps to "hold their hands and whisper in their ears...Neurontin for bipolar disorder." He went further, encouraging them to exceed the FDA recommended dose of 1800 mg/day, adding "I don't want to hear that safety crap." Warner Lambert paid 430 million in fines for its deceptive and illegal marketing of Neurontin to psychiatrists.

Is Neurontin isolated incident? Academic ghost authorship of studies produced by marketing companies is standard procedure. In 2001, drug companies paid $7 billion to a thousand contract research organizations to produce data that put their drugs in a most favorable light. How deeply has this penetrated psychiatry? Some 57 percent of the published scientific articles about Zoloft, for example, were written by the marketing firm Current Medical Directions and ghost authored by academics who had no part in the studies. These articles appeared in top journals including the American Journal of Psychiatry and the Journal of the American Medical Association. "Thus, for at least one anti-depressant, the bulk of the medical literature was literally written by the drug company that manufactured the drug, which is about as glaring a manipulation of science as one can imagine," wrote Carlat. And in a New York Times op-ed piece Carl Elliot wrote, "Pharmaceutical companies promote their drugs with pseudo-studies that have little if any scientific merit."

There are many ways to put your finger on the scales. One is to simply not publish negative results. Not surprisingly, drug company sponsored research is four times more likely to produce positive results than independent research. Wrote Carlat: "If I relied on the published medical literature (and what else can I rely on?) it would appear that 94 percent of antidepressant trials are positive." However, using the power of the Freedom of Information Act, Erick Turner demanded the FDA turn over all antidepressant trial data, and reported in the New England Journal of Medicine that across all the studies only 51 percent of the results were positive. Essentially, you might as well flip a coin.

In The Emperor's New Drugs, Irving Kirsh who also used the Freedom of Information Act to get suppressed FDA research reports, found similar results: 40 percent of antidepressant clinical trial data had been suppressed because they showed negative results. "When we analyzed all the data--those that had been published and those that had been suppressed--my colleagues and I were led to the inescapable conclusion that antidepressants are little more than active placebos."

Not only has the effectiveness of psychiatric drugs been oversold, but the real harm they may be doing has gone mostly unreported. For example, according to an impressive array of evidence presented by Pulitzer Prize nominated investigative reporter Robert Whitaker in Anatomy of an Epidemic, antidepressants appear to increase the lifetime rates of rapid cycling in bipolar patients. So the drugs that provide short-term relief actually worsen the disease they are meant to treat in the long-term. The response has been to add mood stabilizers and anti-psychotics, which have their own often disabling side effects, to offset the long-term instability produced by the antidepressants. So suppressing findings doesn't just give us billion dollar placebos. It gives us patent medicine that may be doing real harm.

Psychiatry, to its credit, has not taken these shocking ethical breeches lying down. Recently, the field had brought in tighter regulations in direct response to this and other scandals. Grand rounds speakers now must disclose their drug company funders; doctors can no longer accept valuable gifts, trips, or lavish meals from drug companies; drug reps' access to residents has been restricted; the FDA puts all results on-line, including negative results. That's progress.

But we need to face facts: Psychiatric research has become corrupted, not around the margins, but at its core. The scientific evidence that underlies psychiatrists' day-to-day prescription decisions is really marketing propaganda packaged as science. As a result, we can no longer trust psychiatrists' judgments and recommendations. "Garbage in, garbage out" is an old research aphorism--if the data is biased the results will be too. In this case, garbage data may be putting garbage toxic chemicals into our patient's bodies. We don't know, and can't know, if the pill psychiatrists are pushing today is the next Neurontin, or worse.

While pharmaceutical companies claim they spend 30 billion dollars a year on research, and this conjures images of bench scientists peering through microscopes searching for the next miracle drug, we now know most of that money is directed toward a wildly successful systematic misinformation campaign that has fooled doctors and harmed patients. The only way the field of psychiatry will ever have credibility again is if we can trust that its science is actually science. The current system of funding psychiatric research has a built-in conflict of interest the industry has shown an unrelenting ability to exploit. It can never be fixed, only at best it can be regulated around the margins. A slide before grand rounds showing the presenter's list of drug sponsors won't do it. The fox can't guard the henhouse. Period. We need a radical solution.

A psychiatric colleague of mine (who asked not to be named in this article) has come up with the only credible plan I've heard that can save psychiatry. Pass a law. Make drug companies give half of its $30 billion in research to the National Institute of Mental Health. Let them dole out the money to independent scientists around the country. The topics of study would be chosen by scientific merit to provide honest answers. The designs employed would be rigorous. The results would be accurately reported, including negative results, side effects, and both short-term and long-term adverse responses. And we could ask questions drug companies don't want us to ask. Are expensive patented drugs really more effective than cheaper off-patent drugs, or naturalistic cures, or therapy treatments?

We need to reevaluate ALL the psychiatric literature with a fine tooth comb. All studies conducted by marketing companies under the false pretenses of ghost authorship must be discarded.We need to figure out how they made it into the best peer reviewed journals and plug that gap.It's urgent that we assess what misinformation has already made it's way into clinical practice, and correct it. If there are more Neurontins out there, every working psychiatrist needs to get the memo. Actually it would be good if they all read the memo about Neurontin. There are still docs using it for bipolar disorder.

Even legitimate studies funded by drug companies in academic settings need new scrutiny. It's human nature to want to please the patron who is writing you a six or seven figure check and helping to make your career. It could influence what might appear to be small things, like not emphasizing problems "just a few" patients had with the drug. Those studies and their data should be reviewed by independent experts. While studies funded by NIMH grants and other independent sources should be given more weight.Maybe drug-money-free studies should have their own prominent logo to alert the reader to their added value.

This pollution of science challenges the legitimacy of the profession. We can't trust psychiatrists' medication recommendations when their "knowledge base" is in large part industry propaganda dressed in scientific clothing.

Not that long ago, most psychiatrists were therapists. But the profession has reinvented itself in a generation because Big Pharma offered them a deal they couldn't refuse. "Doing psychotherapy doesn't pay well enough. I can see three or four patients in an hour if I focus on medications" wrote Carlat. "The income differential is a powerful incentive to drop therapy from our repertoire of skills, and psychiatrists have generally followed the money."

Psychopharmacology has another advantage for psychiatrists: it's turf no other mental health profession can encroach on, whereas therapy has been invaded by psychologists, social workers, and counselors, commoditizing the practice of therapy, and driving down the insurance companies rates of reimbursement A psychiatrist can easily earn $600 and hour doing 15-minute med checks, where a psychologist typically earns $65 dollars an hour as a Blue Cross Blue Shield provider. When I got out of graduate school psychiatrists were earning about 50% more than psychologists. (A joke published in the APA Monitor at that time was "What's the difference between a psychologist and a psychiatrist? Answer: about $40,000 a year.") But now, psychiatrists can earn a 1,000% more.

Big Pharma has made psychiatrists rich, and now they can't live without it. If psychiatrists were not giving out samples and writing prescriptions for this industry's products... what expertise would they have and how could they earn a living? Big Pharma owns them.

Will incidents like the Neurontin scandal lead to fundamental reform? I doubt it. I mentioned the Neurontin debacle to an Ivy league affiliated psychiatric colleague yesterday. He seemed unimpressed. Waving his hand dismissively he said, "Neurontin doesn't work for bipolar disorder. We all know that now," as if it were yesterday's news. "But we're finding it works for anxiety," he added cheerfully. Really, says who? Shrugging off their half-billion dollar fine, it appears Neurontin's manufacturer is now pushing a new off-label use: anxiety. Big Pharma hasn't missed a beat, and psychiatry continues to march to it.

Great article. Big Pharma has no doubt corrupted the field of psychiatry in a big way. I am wondering what your thoughts are on "preferred drug" lists for government funded insurance coverage? I am a mental health and substance abuse counselor in Michigan, and in my state there is an established list of "preferred drugs" that my clients are limited to when written a prescription by our agency psychiatrist. Most of my clients are on Medicaid and those that are not may get coverage through our managed care provider network (Gateway). In many ways, I see preferred drug lists as a positive thing. It has already saved the state millions and on some level does promote more rigourous testing of drugs and seeks to do away with "snake oil" or newly patented drugs that are no better than thier already exisiting parent drug. On the other hand, it seems Big Pharma has readily inflitrated the government selection process and is shelling out big bucks to get certain medications on the preferred drug list with ot without merrit. I would have to check to be sure but based on the number of clients I see who are prescribed Neurontin, I am guessing Neurontin has weasled it's way onto the preferred list where other more effective drugs are not an option for those with government funded insurance.

The "preferred treatment" has nothing to do with drugs, and everything to do with non-drug approaches... ones that are safe and effective.

There are several links on this page, filled with sound research that shows that NOT using drugs (or short-term, followed by slow and safe withdrawal)is a method that runs circles around the current paradigm of care -

I have seen multiple physicians in different health fields for occcipital neuralgia. every one including family physician has gave me antidepressants. when one antidepressant doesn't work, it on to the next physician that the last doctor is sending me to and it's starts all over again. doesn't matter that I tell them. That the injury to the shoulder is referring pain to another injury in neck. insurance wont allow long term therapy. I do what I can on my own. Because i am not better over the years physician label me as non compliant, even though i follow all instructions but now refuse any more pills. I have excepted it is what it is even though its physically painful. why can't physician do the same and not title the patients. it's like it makes them happy if you take the medication regardless of signed effects. their reply," it takes a while for body to adjust to it." I no longer trust any doctor.
burned out on the rodeo. sorry , I am ranting. Your so right about it all. incredibly sad state of affairs to all that trust and become or became harmed by decent of a cure.

All psychiatric drugs cause more harm than good? I can personally attest that ADHD medication has lead to a marked improvement in grades, concentration, self-control, and general quality of life. Natural cures are good because they are 'Natural' right? That's not science. How do you define 'Natural'? Anything can be natural. Many natural supplements can kill you, just like the 'non-natural' cases you are using to say that all researched and refined chemical compounds (and natural cures are nothing but unrefined chemical compounds) Its all about having the right solution to the right problem, natural or not. And that is why we need objective research. That is after all what this article is actually about. Objective information without tainting from marketing ploy's, corporate greed, and other sources of misinformation. ie. people like you who argue based on unsupported sentiments rather than concrete, detailed, researched fact.

All psychiatric drugs cause more harm than good? I can personally attest that ADHD medication has lead to a marked improvement in grades, concentration, self-control, and general quality of life. Natural cures are good because they are 'Natural' right? That's not science. How do you define 'Natural'? Anything can be natural. Many natural supplements can kill you, just like the 'non-natural' cases you are using to say that all researched and refined chemical compounds (and natural cures are nothing but unrefined chemical compounds) Its all about having the right solution to the right problem, natural or not. And that is why we need objective research. That is after all what this article is actually about. Objective information without tainting from marketing ploys, corporate greed, and other sources of misinformation. ie. people like you who argue based on unsupported sentiments rather than concrete, detailed, researched fact.

Great article, but I must tell you that the NIMH ain't exactly squeaky clean either. Yes, in a much saner world the NIMH wouldn't be awash in corruption and we would be able to take up your psychiatric colleague's suggestion that the NIMH should parcel out grants to independent researchers. But that really ain't gonna happen with people like Tom Insel (director of the NIMH) in charge, and all of his pseudo-scientific cronies like Mahukar Trivedi vacuuming up the NIMH grant money for dead-in-the-water studies.

And that's not even the half of it. Read the two links below to learn about how corrupt the NIMH really is.

Dr. Gartner, please do not hesitate to repeat your message whenever you get the opportunity.

You are absolutely correct -- there is no valid research basis for psychiatric prescription. And, given its self-interest in continuing to prescribe, mainstream psychiatry has ignored patient injury that results from, effectively, uncontrolled field experiments by clinicians.

For example, it is striking that, although there are thousands upon thousands of postings all over the Internet and dozens of patient-run Web sites specifically about the difficulties of antidepressant withdrawal, clinicians know virtually nothing about how to safely taper people off the medications.

Mainstream psychiatry tells doctors that withdrawal symptoms are minor, transitory, and last at most a few weeks; doctors are instructed that any further symptoms are relapse or emergence of a new psychiatric disorder. They then prescribe ever-more bizarre drug cocktails to combat this new "illness" as the patient deteriorates under the weight of chemical assault.

This, as I said, despite the evidence of thousands upon thousands of Web postings.

Mainstream psychiatry has yet to catch up with the reality of psychiatric drug withdrawal syndromes and how they create an epidemic of mental illness (as suggested by Robert Whitaker). So much suffering could be prevented if it weren't for the assumptions of drug safety promulgated by the unholy symbiosis of psychiatry and pharma.

Discussing psychiatric research here, I am reminded of a scene from one of my favorite Woody Allen movies, Annie Hall:

Allen's character stands in line with his girlfriend, Annie Hall. Behind them stands another guy pontificating to his date about the meaning of Marshall McLuhan's work. Then the real Marshall McLuhan steps out from behind a movie poster. McLuhan exhorts: I heard what you were saying. You know nothing of my work!

I wish some real physician scientists would step out in public and engage critics of psychiatry. The interchange, the conversation is in the public interest. For your readers in Washington D.C., a couple of giants in the field are putting themselves out there to the public.

Dr. Frederick Goodwin speaks on achieving and maintaining wellness on Tuesday, October 12, 7:30 pm, at the George Washington University Medical Center auditorium.

Dr. Robert Post offers Ask A Doc on Tuesday, November 8, 7:30 pm, also at George Washington University Medical Center auditorium.

Please see the website of the Depression and Bipolar Support Alliance for directions: www.dbsanca.org

Demonize ALL psychiatrists? The devilish ones are often the most astute observers of the human condition.

Who can dispute your figures about DBSA national? That is important information to consider. I wish DBSA were sponsored by the makers of puppy chow, or bottled waters, or stretch pants instead.

Psychology Today takes pharma money, but here I find Robert Whitaker, Nassir Ghaemi and now this blog, too.

The talk I mention in my previous post is sponsored by a local chapter of DBSA. They have 1000 or so chapters. Our local chapter is small potatoes--no paid staff, no office. We give DBSA national money and not the other way around.

The two doctors I'm suggesting as an antidote to despair about psychiatry, Dr. Goodwin and Dr. Post, they do accept money from pharmaceutical companies also. They could speak to how they avoid conflict of interest. I can't begin to explain.

My point, as if I ever have one, is that tough questions will be respectfully entertained by these guys. They can handle all the questions raised by this blog entry.

Psychology today doesn't receive FINANCIAL SUPPORT from big pharma. They run ads and get paid to do it. There is a big difference. In this latter case Big Pharma NEEDS THEM, not the other way around as is the case with the DBSA. Sure, Big Pharma could try to influence content on this website by threatening to take their ad money elsewhere but then they would also be losing business. In no way can they tell PT "Either you screen this content out OR WE'LL SHUT YOU DOWN!"

Though I applaud Dr. Gardner for his exposure of the fraud and damage done by psychiatry in bed with BIG PHARMA, he doesn't go far enough. I am dismayed that he refers to the latest fraud fad stigma of bipolar disorder II, which was invented when psychiatry and BIG PHARMA needed fresh victims for its new lethal so called mood stabilizers like Depakote and the atypical antipsychotic poisons. He also repeats the lie that SSRI antidepressants make bipolars rapidly recycle when these horrible drugs cause mania and other lethal effects in normal people falsely labelled bipolar knowingly by the mental death profession. Dr. David Healy, psychiatrist, discusses this fraud and conflicts of interest behind the explosion of bogus bipolar diagnoses which became a literal joke in psychiatry. Even Dr. France Allen, editor of the bogus DSM IV, has admitted that by expanding the criteria for ADHD, autism, bipolar and other labels invented by psychiatry and BIG PHARMA, they did much harm by fueling an epidemic of bogus diagnoses that destroyed countless lives. So, Dr. Gardner should not just point the finger at psychiatry since he is prostituting himself by using bogus lables from the junk science DSM to stigmatize normal people having life problems/crises who have no idea the evil lurking behind the doors of the mental death profession. Dr. Gardner misinterprets Robert Whitaker's ANATOMY OF AN EPIDEMIC in that he exposes that those in third world countries who go through similar life crises tend to recover with community support and no drugs while those preyed upon by the mental death profession in supposed advanced countries are stigmatized with a death sentence fraud label like bipolar to force lethal poisons on them guaranteed to make them permanently disabled. So, Dr. Gardner you are a huge part of the problem too since you are colluding with this evil, corrupt, bogus fraud!!

Though I applaud Dr. Gardner for his exposure of the fraud and damage done by psychiatry in bed with BIG PHARMA, he doesn't go far enough. I am dismayed that he refers to the latest fraud fad stigma of bipolar disorder II, which was invented when psychiatry and BIG PHARMA needed fresh victims for its new lethal so called mood stabilizers like Depakote and the atypical antipsychotic poisons. He also repeats the lie that SSRI antidepressants make bipolars rapidly recycle when these horrible drugs cause mania and other lethal effects in normal people falsely labelled bipolar knowingly by the mental death profession. Dr. David Healy, psychiatrist, discusses this fraud and conflicts of interest behind the explosion of bogus bipolar diagnoses which became a literal joke in psychiatry. Even Dr. France Allen, editor of the bogus DSM IV, has admitted that by expanding the criteria for ADHD, autism, bipolar and other labels invented by psychiatry and BIG PHARMA, they did much harm by fueling an epidemic of bogus diagnoses that destroyed countless lives. So, Dr. Gardner should not just point the finger at psychiatry since he is prostituting himself by using bogus lables from the junk science DSM to stigmatize normal people having life problems/crises who have no idea the evil lurking behind the doors of the mental death profession. Dr. Gardner misinterprets Robert Whitaker's ANATOMY OF AN EPIDEMIC in that he exposes that those in third world countries who go through similar life crises tend to recover with community support and no drugs while those preyed upon by the mental death profession in supposed advanced countries are stigmatized with a death sentence fraud label like bipolar to force lethal poisons on them guaranteed to make them permanently disabled. So, Dr. Gardner you are a huge part of the problem too since you are colluding with this evil, corrupt, bogus fraud!!

No one disputes climate change, but anthropogenic global warming/climate change doesn't exist. It was going on long before the industrial revolution.
That said, an earlier commenter is correct - Dr. Gardner didn't go far enough. People who take psychiatric drugs end up dying 25 years earlier than people who don't. Psychiatry is definitely always creating new "mental illnesses" for their products and discontinuing other "mental illnesses" because it's politically incorrect to keep them in the DSM. Funny it doesn't work that way with REAL illnesses.

ANTIPSYCHOTIC DRUGS CONTAINS PESTICIDE, HOWEVER BECAUSE THE FINAL FORMULA (NCH3) IS ACHIEVED THROUGH METHYLATION OF PESTICIDE IODOMETHANE: http://en.wikipedia.org/wiki/Methyl_iodide - AND SILVER NITRITE: http://en.wikipedia.org/wiki/Silver_nitrate - THE PESTICIDE IS UNDETECTED BUT INSTEAD NITROGEN MONOXIDE CAN BE SEEN IN CHEMICAL ANALYSIS.
AS THE RESULT OF THE MIXTURE OF TWO, A CLEAR POLLUTION IS PRODUCED. IN 80S IT WAS A VERY TIRESOME TASK TAKING A WALK IN BUSY LONDON STREETS. THOSE TIMES THIS WAS WRONGLY CONNECTED WITH HIGH POWER CABLES PASSING THROUGH UNDERGROUND POWERING TUBE TRAINS.
IT WAS HOWEVER DUE TO THE POLLUTION EXHALED FROM VEHICLES USING LEADED PETROL. SINCE THE USE OF LEADED PETROL WAS LIMITED AND ALSO HENCE THE CONGESTION CHARGE HAD BEEN INTRODUCED ONE CAN TAKE A QUITE A LONG WALK THROUGH THE STREETS OF LONDON PROVING ONE IS NOT AFFECTED BY THE WEATHER CONDITIONS:
NITROMETHANE: http://en.wikipedia.org/wiki/nitromethane#as_an_engine_fuel
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"HIPPOCAMPAL DYSFUNCTION MIGHT ACCOUNT FOR DISTURBANCES IN LONG TERM MEMORY FREQUENTLY OBSERVED IN PEOPLE WITH SCHIZOPHRENIA
http://en.wikipedia.org/wiki/Hippocampus#Schizophrenia

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METHYLNITRENE (NCH3): http://www.chemicalbook.com/chemicalproductproperty_en_cb6106836.htm
METHYL NITRITE CAN BE PREPARED BY THE REACTION OF SILVER NITRITE:
http://en.wikipedia.org/wiki/Methyl_nitrite#Synthesis
WITH A IODOMETHANE: http://en.wikipedia.org/wiki/methyl_iodide#use_as_a_pesticide

AND METHYL NITRITE: http://en.wikipedia.org/wiki/methyl_nitrite#synthesis IS FORMED.

METHYL IODIDE HAD BEEN APPROVED FOR USE AS A PESTICIDE BY THE UNITED STATES ENVIRONMENTAL PROTECTION AGENCY IN 2007 AS A PRE-PLANT BIOCIDE USED TO CONTROL INSECTS, PLANT PARASITIC NEMATODES, SOIL BORNE PATHOGENS, AND WEED SEEDS.

AS WE MENTIONED ABOVE THIS COMPOUND IS PRODUCED BY THE COMBUSTION OF UNLEADED PETROL, AND MIGHT BE A CAUSE OF THE DECLINE OF INSECTS, AND HENCE THAT OF THE HOUSE SPARROW AND OTHER SONGBIRDS IN EUROPE.

METHYLATION IS A FORM OF ALKYLATION WITH, TO BE SPECIFIC, A METHYL GROUP, RATHER THAN A LARGER CARBON CHAIN, REPLACING A HYDROGEN ATOM: http://en.wikipedia.org/wiki/Methylation

The problem is that people who have conceived 'guilt/shame', along with feeding the inferior self; use labels as a tool, because guilt/shame, and the inferior self, shifts the blame and creates defense mechanisms. I discovered this from the people that have conceived these lies: depression, schizophrenia, bipolar, and borderline personality. They have all admitted to having guilt and shame, and ‘fear of embarrassment’. When you talk about your personal problems, and you talk with people on that intimate level; you talk with people that are at your level. Psychologist are equal to their client, and the client is equal to them. They are living in a denial. The pharmaceutical companies are gladly able to use them because denial needs excuses: depression, bipolar, schizophrenia etc. And so does pharmaceutical companies. Yes, those excuses are also the pharmaceutical companies excuse, to dish out pills. But, many people in the general population have guilt shame and a sense of being inferior and they need an excuse. It’s a full circle, so to speak.

Kid/teen conceives one or more of these: approval problem, guilt/shame, 'fear of humility' and pride. They need mass amounts of denial material: DSM, MH forums, MH articles etc. They pursue the ultimate exposure, but think it's a cover - MH career. They validate themselves through their client. The psychologist's need for validation inadvertently comments the Drug industry's need for an excuse and validation.

It is beyond doubt that there is no signature genetic inheritance with any family tree; just about 75% of the population has self conceived these self reflective projections: depression, bipolar, schizophrenia etc. It’s just in EVERY humans capacity to be able to make choice, and one can choose to become ill willed with ‘guilt and shame’ and a sense of being ‘inferior’, with of ‘fear humility’, and a choice to wallow in Pride and Denial.. Yes, it’s expression is redundant vague and self reflective impressions – it’s the ‘art’ of self deception.

IA

I must not hide the fact that the majority of the ones that have admitted this to me (guilt shame and fear of humility etc.), have repeatedly mentioned that their label is ‘guilt and shame’. So it is likely that once they have used the label, and proclaim themselves to have this label; that its the trap that they put themselves in, and they have also mentioned rambling thoughts that they are a liar, a hypocrite and a fake.